5 July 1999
Dear Readers: Sincerely,
Dr. Warren hopes to help all who ask his advice and to enlighten all who read Ask Dr. Warren. For your own well being please keep in mind that
advice you read here may not apply exactly to your own situation, and that if you are sick, no information on the web can take the place of a hands on examination by your physician who knows you and cares about you.
Dr. Warren
Thank you.
-KH
Dear KH: If your child is ill, it is difficult to explain why she seems healthy during the day but vomits in her sleep. An occasional occurrence of this sort can happen, but 10 times in three weeks is hard to ignore, therefore, she should see her doctor.
The one thing that comes to my mind that may cause this symptoms is gastroesophageal reflux. The reflux may occur only when your child is lying down and cause pain in the esophagus (felt in the chest), and vomiting.
If these symptoms persist, I would like to know what your doctor finds as the cause, so stay in touch.
Sincerely,
Dr. Warren
She has been on and off propulsid which helps to an extent. The specialist that she has been seeing does not want her passing solid stools until she is potty trained.
The problem is that she is to the point that she is refusing to eat very often and that is making the problem even worse. Now she has gone back to crying terribly whenever she tries to have a bowel movement (which is part of what started us looking for a problem when she was 3 months old). She has also started vomiting at night. Three or four times a week, she winds up vomitting what looks like curdled milk.
I am at my wits end and not sure where to turn next.
I would appreciate any help you could offer on this situation.
Thank you.
-JC
Dear JC: The problem you describe sound a bit more complex than just dealing with constipation. Even with severe constipation children should not vomit. You told me that your child has been on propulsid, but you didn't mention anything else aimed at keeping the stool soft such as senokot, mineral oil, fiber, or prune juice. I'm reluctant to make suggestions since I don't know what you've tried and I think the problem sounds like more than just getting the stool softer. You should make an appointment with your pediatrician or your pediatric gastroenterologist.
Sincerely,
Dr. Warren
-RU
Dear RU: The bacteria that cause tooth decay live on the sugar in food. The longer the sugar is in contact with the teeth, the greater the risk of decay. It doesn't matter if it happens because the baby falls asleep with a bottle in his mouth or because he sips a bottle all day long. If the teeth are bathed in sugar from milk or juice over a prolonged period of time, there is a high risk of dental decay. If a baby takes a bottle, drinks it quickly, and then tosses it out, even if he is lying in his crib and goes to sleep right afterward, the risk is small. The risk is less if his teeth are cleaned before he goes to sleep or he drinks some water to rinse the milk or juice off his teeth.
Sincerely,
Dr. Warren
Sincerely,
-Leigh Ann
Dear Leigh Ann: If your period comes "late" every month, but comes every month, it just means you have a long cycle. Not everyone menstruates every 4 weeks. Some women regularly go 5 to 6 weeks between menses. That's perfectly normal.
Sincerely,
Dr. Warren
I've read that milk is also an important source of other nutrients and we don't want her to give it up entirely if we can help it. Should we continue to offer milk in her sippy cup? Are there other food sources that can supply the nutrition that comes in milk? Is her refusal unusual in a toddler of her age?
Sorry for so many questions, but we are worried parents right now!
-TE
Dear TE: Many toddlers give up milk when they give up their bottles. Keep offering the milk in a sippy cup. Eventually your daughter may take it. Milk is an excellent source of protein, but so is meat, fish, and eggs, as well as other dairy products like yogurt and cottage cheese. You could try Pediasure which is a flavored nutritional supplement. For that matter, Children's Mylanta can be used as a calcium supplement.
Sincerely,
Dr. Warren
Thank you in advance.
-KH
Dear KH: Hirschsprung Disease results from absent ganglion cells (nerve cells) in the bowel wall. This results in absence of movement of the area without ganglion cells and causes a relative degree of obstruction with constipation and abdominal distention. Diagnosis can be made by rectal biopsy which can be done through the rectum. Surgery is required for treatment.
Sincerely,
Dr. Warren
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